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on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose their business. mr. smith, are you aware of this provision? >> i am not familiar with that section. >> let me ask you this. in this provision, you may not know this either, but the word quality is not defined in the statute. it is safe to assume that the secretary, not just secretary sebelius, but every secretary to follow, would be able to define for regulation what that word quality means. yes or no? >> i believe that is the correct interpretation. again, we have tried to introduce quality performances into a variety of parts of our programs, both in managed care, both in the fee-for-service world, and this is another one of our concerns that we
a loss so vast. the aca is not just above the expansion of medicaid or establishing an insurance exchange, it is about the hundreds of federal mandates and procedural requirements that have the escaped public attention, but to which we by law must obey. the fine print of the legislation is so complex, even the federal government struggles to understand it. the states cannot fully understand the impact on finances, systems changes, and operations. this law completely overwhelms society's safety net for the needy. there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will
that must be covered by any health plan offering a plan in the aca exchange. i understand this has far reaching consequences on premiums. benefits must be provided. according to the notice in the federal register, the rule was approved by administrator on august 1, 2012. that is three months before. yet the role did not receive approval from secretary sebillius until two weeks ago. what did it take two month for the administration staff to review -- and yet the public will have only four weeks to review during the period of public comment on the ruling issued on november 26? i would note this is a time of year when people's focus is generally on things other than long awaited rules. >> we put a bulletin on the essential health benefits quite some time ago and got comments on the bulletin. the public had an opportunity to provide public comment on essential health benefits before the proposed rule was put out. there were some changes from what had been in the bulletin, but by and large what is in the bulletin is what is a in the proposed rule. i think there has been ample opportunity fo
recovery. in terms of health care costs related to the aca, while most business leaders that we have spoken to have said is they understand we needed to do something. small-business owners are impacted disproportionately by rising health-care costs. the current health c arpl work for them less well thanlarg companies because they don't have buying power. if you look at some of the reforms, you see a number of efforts to try to reduce costs for small businesses to, like creating exchanges, for example. small in 2011, small businesses paid 25% more for insurance than large companies. the exchange is meant to help small business. you are right. with the new regulations set to take effect in a couple of years, it is another reason to be careful and protect small businesses from tax increases. what the obama people will tell you is that they have cut taxes for small business 17 times and 90% of the small businesses in america would not be effected by higher individual taxes. host: here is "the miami herald" this morning. pennsylvania. independent caller. caller: he said it earlier when they go t
are trying to do that, implementing thea aca. i feel strongly of rewarding doctors differently, in a way that rewards success. in those discussions, are there other ways we can see revenues come in from within the health- care system? i think that is on the table. i am not keen on raising the age for medicare. we have to help figure out how to a group of people figure out how to get health college. that is the cost of subsidies. do they go into the exchange. for medicare, the use of the least expensive seniors we have, 65 and 66 year olds. the most expensive seniors are much older. you have to look at the consequences and whether that is a cost savings at the end of each day for government and for families. >> one final question on the immediate and we will go back to the broader agenda. the president had a firm statement this week about the test ceiling where he says, i will not play that game, meaning he will not negotiate for raising the debt ceiling. how was that going to work? does that need to be part of any agreement to appoint -- agreement to avoid the fiscal cliff? >> this is se
at the internet and say do we have to draw lines here? have we gone too far? i personally think my position on a.c.a. is a good position and protecting the people's right to know is a high priority. >> what have you decided to do with all your papers and years in congress? >> that is an important question. i'm pleased to say that my alma mater at ucla is taking some interest. hopefully, some of that work will be of value to researchers sometime out there. >> you have expressed optimism and interest of what your future might hold but it has to be difficult leaving this institution after so many years. this has been most of your adult life, your way of life. how are you using these last few weeks here, still as a voting member of congress? is the experience -- does it feel different saying this might be the last time i will do this? >> i was looking at my cad and wondering how many more votes i have left. if i thought this was the end of impacting public affairs i would be very nostalgic. we're looking at it as another chapter in life -- the book of life that we look forward to. >> do you plan to make
the economic recovery. in terms of health care costs related to the aca, while most business leaders that we have spoken to have said is they understand we needed to do something. small-business owners are impacted disproportionately by rising health-care costs. the current health care plans work for them less well than they do for larger companies because they don't have buying power. if you look at some of the reforms, you see a number of efforts to try to reduce costs for small businesses to, like creating exchanges, for example. small businesses in 2011 paid about 25% more for health care insurance than large companies. you are right. with the new regulations set to take effect in a couple of years, it is another reason to be careful and protect small businesses from tax increases. what the obama people will tell you is that they have cut taxes for small business 17 times and 90% of the small businesses in america would not be effected by higher individual taxes. host: here is "the miami herald" this morning. pennsylvania. independent caller. caller: he said it earlier when they go to wa
. we are trying to do that. implementing the aca is important in terms of delivery reforms. it pays doctors differently. it rewards quality. we should do that sooner than later. save those dollars sooner. in those discussions, are there other ways that we can see revenues come in from within the health-care system? that is on the table. i am not keen on increasing the age on medicare. we have gone through a really big debate about finding a way to have all americans have health insurance. that is taking a group of americans and figure out how they afford health coverage. that shifts the costs of subsidies and they go into the exchange. does makes it more expensive for younger people because the older cohort is in that group? for medicare, these are the least expensive seniors we have. the most expensive seniors are much older. you have to look exactly at the consequences and whether that is cost savings for government and families? >> the president had a firm statement this week to the business roundtable about the debt ceiling where he said, i will not play that game. he will not n
will lose access to critical health services covered in the a.c.a. like cancer screenings. and the last step is to go after another favorite g.o.p. target and that's social security. house republicans have only one to protect and that's the wealthiest americans. it couldn't be more obvious. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from wisconsin. mr. ryan: i yield three minutes to the chairman of the commerce committee, mr. upton. the speaker pro tempore: the gentleman from michigan. up up -- mr. upton: we work to get our $16 trillion national debt under control and we put us on a path towards a more solemn fiscal future. the spending reduction act of 2012, we identified key areas to reduce spending to replace the sequester and without this thoughtful balanced package of savings, in two weeks, the sequester is going to cut discretionary spending while shielding the lion's share of the government's budget from reduction. critical priorities such as important cancer research at the n.i.h. and review of budget
gone too far? i personally think my position on a.c.a. is a good position and protecting the people's right to know is a high priority. >> what have you decided to do with all your papers and years in congress? >> that is an important question. i'm pleased to say that my alma mater at ucla is taking some interest. hopefully, some of that work will be of value to researchers sometime out there. >> you have expressed optimism and interest of what your future might hold but it has to be difficult leaving this institution after so many years. this has been most of your adult life, your way of life. how are you using these last few weeks here, still as a voting member of congress? is the experience -- does it feel different saying this might be the last time i will do this? >> i was looking at my cad and wondering how many more votes i have left. if i thought this was the end of impacting public affairs i would be very nostalgic. we're looking at it as another chapter in life -- the book of life that we look forward to. >> do you plan to make a good- bye speech on the floor? >> i said a
of 2010, the congressional budget office was projecting out some savings because of the a.c.a. but they were figuring about 4% per capita growth, again as you pointed out this chart now shows we're down to 2%. so they've been revising their estimates over the last two years and the net savings, the recalculation just in the last two years has been hundreds of billions of dollars of lower expenditure than they had first thought was going to be the case. when you compare that magnitude of savings with, for example, raising the eligibility age to 67, i mean, they're dwarfed. it is really just a small portion of what efficiencies in the system are capable of producing. and the fact of the matter is that raising the eligibility age, i mean, there's no free lunch. the fact is that even though these are people that willing challenged in the private insurance market, 65 and 66 are still the healthiest population within the medicare pool. so the ones who remain in medicare, their part b premiums are going to go up and that's not just me saying it, it's the keiser family foundation who
Search Results 0 to 14 of about 15 (some duplicates have been removed)